What Happens to Blood Glucose Concentrations After Oral Treatment for Neonatal Hypoglycemia? - 01/11/17

Abstract |
Objective |
To determine the change in blood glucose concentration after oral treatment of infants with hypoglycemia in the first 48 hours after birth.
Study design |
We analyzed data from 227 infants with hypoglycemia (blood glucose <46.8 mg/dL, 2.6 mmol/L) born at a tertiary hospital who experienced 295 episodes of hypoglycemia. Blood glucose concentrations were measured (glucose oxidase) within 90 minutes after randomization to dextrose or placebo gel plus feeding with formula, expressed breast milk, or breast feeding.
Results |
The overall mean increase in blood glucose concentration was 11.7 mg/dL (95% CI 10.4-12.8). The increase was greater after buccal dextrose gel than after placebo gel (+3.0 mg/dL; 95% CI 0.7-5.3; P = .01) and greater after infant formula than after other feedings (+3.8 mg/dL; 95% CI 0.8-6.7; P = .01). The increase in blood glucose concentration was not affected by breast feeding (+2.0 mg/dL; 95% CI −0.3 to 44.2; P = .09) or expressed breast milk (−1.4 mg/dL; 95% CI −3.7 to 0.9; P = .25). However, breast feeding was associated with reduced requirement for repeat gel treatment (OR = 0.52; 95% CI 0.28-0.94; P = .03).
Conclusions |
Treatment of infants with hypoglycemia with dextrose gel or formula is associated with increased blood glucose concentration and breast feeding with reduced need for further treatment. Dextrose gel and breast feeding should be considered for first-line oral treatment of infants with hypoglycemia.
Le texte complet de cet article est disponible en PDF.Keywords : infant, newborn, treatment, feeding, infant of a diabetic mother, preterm
Plan
Funded by the Waikato Medical Research Foundation (171), the Auckland Medical Research Foundation (1110009), the Maurice and Phyllis Paykel Trust, the Health Research Council of New Zealand (09/095), and the Rebecca Roberts Scholarship. Data management and analysis was funded in part from the Health Research Council of New Zealand (10/399) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (R01HD0692201). The authors declare no conflicts of interest. |
Vol 190
P. 136-141 - novembre 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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